What does a diaphragm cost? The cost of a diaphragm varies from $75 to $100.

Some other questions people ask about diaphragms

Q. I’ve heard about a flat spring diaphragm, what is it?

A. A flat spring diaphragm is very similar to a coil spring diaphragm, but the spring is flat, not coiled. It is available in other countries but is no longer available in Australia.

Q. Can I use a diaphragm if I am using a vaginal cream for thrush?

A. You should not use diaphragms, caps or condoms if you are using vaginal creams for thrush because those creams are oil based and they can damage latex. The latex could tear or crack or get a hole in it and then you could get pregnant. It is best to avoid penis-in-vagina sex until a week after you have finished treatment for thrush.

Q. Can all women use a diaphragm?

A. No, diaphragms do not fit properly in some women’s vaginas.

Often those women find that a cervical cap suits them best. Q. Can a man feel the diaphragm when it’s in place? A. Most men can’t feel it and those who can don’t usually think it’s a problem. If your partner says it’s uncomfortable, it may not be in the correct position.

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Condom impotence is widespread and happens to young and old alike. It can become such a problem that some men are driven to take drastic steps. Some go so far as to request vasectomies and others abstain from full sexual activity.

Recently two youngish men turned up at the Men’s Medical Clinic in Sydney both requesting vasectomies. They had been attending the clinic for other male problems but, during the history-taking, disclosed the real reason for their vasectomies. One was a professional man in his early forties, the other a tradesman in his mid-thirties. Both had tried to use condoms for contraception rather than for protection against sexually transmitted diseases. But despite genuine and repeated attempts, neither could ‘perform’ while wearing one. Full erectile capability returned once the sheaths were out of sight. If a man has performance anxiety and is not sexually confident, rolling on a condom may be enough to sabotage the intercourse.

Condom impotence can be a particular problem for older men. As men age, their erections become more fragile, and consequently they often become anxious about them. They find it difficult to maintain erections during the break in stimulation that occurs when the condom has to be put on. Anxiety about this break and about their fragility may bring on an adrenalin rush that automatically causes detumescence. This adrenalin surge makes an erection physically impossible. Older men tend to report condom impotence more than younger men, but it is not something they feel comfortable talking about.

One method of overcoming such anxiety is to combine condom use with a special injection which brings on an erection and maintains it for thirty to sixty minutes.

This method takes time, but within six months, most men should have regained enough confidence to be able to use condoms freely.

Historically, condoms have had a poor reputation. Until the late 1930s they were thick, rubbery and reusable. There was a widespread perception that they cut sensation and dulled the sexual pleasure for both participants.

This view persisted, and when schoolboys in the 1960s were surveyed about condoms, their response was overwhelmingly negative. Their fathers had told them that the rubber was so thick it mined all the fun. Today, many older men still hold this view, which may be a factor in their condom impotence. The expectation of significantly reduced sensation may make them anxious.

But condoms have changed. According to Ansell International, one of the world’s largest manufacturers of condoms, the first condom revolution took place in the late 1930s when the heavy robber was replaced with finer latex. Manufacturing was again refined in the 1970s, and today ultra-thin’ condoms are available. Despite this, patients continue to complain that condoms make them feel their penises are anaesthetised. But there are simple ways of preventing condom impotence. Many people wouldn’t know, for example, that caressing the testicles results in an automatic erection by spinal reflex mechanism. Doing this at the time of putting on a condom may help to overcome erectile failure.

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To insert it:

1. Carefully tear open the packet. Although the polyurethane that the female condom is made from is pretty strong it is still possible to tear it with your fingernails or the sharp edge of a ring.

2. Rub the sides of the female condom together to spread around the lubricant that is already on it

3. Look at the flexible ring around the open end. We’ll call this the outer ring. There is another one at the closed end, and we’ll call this one the inner ring. If you know what a diaphragm looks like, the ring is about the same size as the rim of a diaphragm, and you put the inner ring into your vagina as though you were putting in a diaphragm.

4. Hold the inner ring between the thumb and middle finger of one hand.

5. Squeeze the inner ring to make a long thin shape.

6. With your other hand hold the lips of your vagina apart.

7. Slide the female condom while it is still squeezed, into your vagina and push it gently down and back as far as it will go. When it is in the right position you won’t be able to feel it. Don’t worry, it can’t go too far inside you, and it won’t hurt

8. The outer ring should fit just outside the vagina.

9. Make sure the female condom is not twisted inside your vagina.

10. Just before you are going to have sex you may want to add more lubricant

11. Guide the penis into the outer ring so that it doesn’t go in between the female condom and your vaginal wall, or you could get pregnant.

After sex you don’t have to remove the female condom right away, but it is best to take it out before you stand up.

To remove it

1. Take hold of the outer ring, squeeze it and then twist it to keep the semen inside.

2. Pull the female condom out gently, wrap it in a plastic bag and throw it in the bin. Do not flush it down the toilet.

3. Each time you have sex use a new female condom.

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The creature was Priapus, the Roman god of fertility who, over the years, had suffered a severe loss in status and become the protector of gardens and orchards. But while he had lost his power, he hadn’t lost his potency, and today Priapus’s name is invoked every time a doctor treats a man struggling with an erection that won’t go down.

The term priapism is used for a prolonged erection, usually associated with pain and unaccompanied by sexual desire.

It is not uncommon for erections to last half an hour in younger men, and they can last longer with minimal stimulation.

An erection is said to be prolonged if it lasts more than two hours. There is no fixed limit, but some doctors say that after four hours men should see a doctor. At six hours they may need urgent urological attention. Past six hours an erection may begin to damage the cells of the penis. They agree that after twenty-four hours the damage can lead to permanent impotence.

There are two main types of priapism. The first is ‘arterial priapism’ and usually results from an injury to the arteries supplying the penis with blood. These arteries run very close to the perineum (the body surface between the thighs) and can be damaged by injury to this area. The injury may be blunt, like falling onto the crossbar of a bicycle or getting kicked, or may be penetrating, like being speared. The damaged artery cannot regulate the amount of blood going into the penis. Blood continues to flow in and fill all available space without control. For this reason the condition is also known as ‘high-flow priapism’.

While it is an unusual disorder it is also likely to be under-reported. Men are loath to report it. To relieve the discomfort some attempt intercourse but find it too painful. Eventually, when pain outweighs embarrassment, they go to hospital.

As with most medical conditions, the shorter the interval between the onset of the symptoms and the treatment, the better the results. Doctors can drain the blood and, depending on the damage, can repair the artery so the problem does not recur.

The second and more common type of priapism involves the veins and is known as Venous’ or ‘low-flow’ priapism. The veins don’t carry the blood away from the penis efficiently. A persistent obstruction in the penile vein usually blocks the outflow. Blood is trapped inside, making the erect penis very rigid and painful. This condition can be caused by a rare disease known as sickle-cell anaemia or by some antidepressants (not any of those available in Australia) but today is mostly caused by penile injections.

In the last few years penile injections have become a popular method of treating impotence. Clinics which specialize in treating impotence have popped up all over the place. Many are basically injection clinics. They teach men how to self-inject to bring on an erection.

Priapism is a known complication of the drugs they inject. Some men overdose in the hope of getting a bigger and better erection, but what they are left with is an erection that won’t go down and hurts. When using these injections, it is better to underdose.

Doctors disagree on how best to treat priapism. If left alone to wait for the erection to disappear, a patient may become completely impotent because fibrotic lesions develop.

Some doctors spend the first few hours treating priapism with pain-killers, ice-water enemas, and drugs to lower blood pressure. If the man fails to respond, more aggressive measures are implemented. The hard body of the penis is pierced with a needle so blood can escape. If dark, almost black, blood comes out, the penile compartment is washed out with saline until the return flow is pink and proper drainage is established.

After self-injection, some doctors recommend Sudafed tablets. These may stimulate the nerves which cause detumescence. If this fails, they say Sudafed should be taken again two hours later. If the erection persists, a doctor will have to drain the blood.

As the risk of impotence is so substantial, some doctors insist on explicit consent before they treat a prolonged erection. But reassuringly, if the priapism is not of long standing, treatment is usually quite successful.

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Generally condoms are a light creamy brown colour, with a thin rim at the open end, and the closed end is either plain and rounded, or has a little teat- or nipple-shaped space right at the tip.

Are there different types of condoms? You can get lots of different types of condoms. They come in a range of colours … red, blue … black. You can choose special flavours like strawberry and banana. There are several different shapes. You can get straight, flared, or contoured and some have ribbed or dotted textures. Condoms can have different shaped ends, and you can get them already lubricated, or lubricated with spermicide.

Fancy condoms are not always as reliable as the plain ones and it is a good idea to read the label on the packet to be sure they are meant to be used for protection against pregnancy and sexually transmitted infections (STIs), and not just as novelty items.

Some condoms are made of stronger, thicker latex than others, and some are made of very fine latex. Generally they are one size fits all. That is because although penises are different sizes when they are soft, when they are erect they all tend to be about the same size. You can get condoms that are a tighter fit, and condoms that are contoured may suit men who want them slightly smaller. Condoms that are flared sometimes suit men who want them slightly larger.

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